Femoral hernia

　　Medical research shows that the cause of inguinal hernia is more common in women over the age of 40, which is closely related to their physiological and anatomical basis. The inguinal ring is the upper opening of the inguinal canal, which is only covered with loose connective tissue. The inguinal canal is a conical blind tube, with a considerable part of its anterior wall located within the saphenous hiatus. Its superficial structure is the reticular fascia, without muscular protection. The insertion of the inguinal falx is narrow and far from the pubic symphysis ligament. The female pelvis is wider, and the ligaments, muscles, and vessels are thinner than in males, so the inguinal ring is significantly larger in females and is considered one of the main reasons for the occurrence of inguinal hernia.

　　In addition, changes in the thickness of the external iliac vein can also have a direct impact on the opening of the inguinal ring, especially in the middle and late stages of pregnancy when uterine compression leads to venous reflux obstruction in the external iliac and femoral veins, causing vessel thickening. After delivery, the relief of vascular compression results in a decrease in diameter, which will undoubtedly affect the size of the inguinal ring and its adjacent spaces. Pregnancy can cause the stretching of the abdominal muscles and the relaxation of tendons. Due to the special anatomical characteristics of the inguinal ring, these structures become more fragile. Any factor that increases intra-abdominal pressure, such as bloating, constipation, bronchitis, liver cirrhosis with ascites, and other diseases, as well as the aging process, chronic消耗性疾病, muscle atrophy, or degenerative changes, can trigger an inguinal hernia.

　　In addition, the occurrence of inguinal hernia may be related to inguinal hernia repair surgery. It is reported that more than 25% of patients with inguinal hernia have a history of inguinal hernia repair surgery. This is because traditional inguinal hernia surgery uses the inguinal ligament for repair, which is pulled up and lifted, causing tension suture repair to open up the inguinal ring, providing an easy way for hernia protrusion.

　　Intestinal necrosis and fistula are serious complications of incarcerated hernia of the thigh. After the hernia of the thigh is incarcerated, if strangulation occurs and the hernial contents necrose, purulent lymphadenitis or other abscess-like changes will appear, and once it is incised, it will cause an intestinal fistula. Fistula (fistula of intestine) refers to pathological channels between intestinal tracts, between intestinal tracts and other organs, or between the body and the outside world, causing the excretion of intestinal contents from the intestinal cavity, causing a series of pathophysiological changes such as infection, fluid loss, malnutrition, and organ dysfunction. Fistula can be divided into two types: internal fistula (internal fistula) and external fistula (external fistula).

　　Although the pelvic bone of women is wider, and the gap below the inguinal ligament is also wider, women are more prone to develop hernia of the thigh than men, but hernia of the thigh is still much less common than inguinal hernia.

　　Usually, there is no special discomfort in hernia of the thigh, and there is only a circular mass near the lower part of the inguinal groove below the thigh root. Because the inguinal canal is thin, the hernia path is tortuous, and it is not easy to reduce or completely reduce the hernia mass or make it disappear when lying flat and resting. The coughing impact is also not obvious.

　　About half or more than half of the hernias of the thigh can complicate with incarceration and strangulation, often due to acute abdominal pain or strangulated intestinal obstruction. Therefore, when examining patients with acute abdominal pain, the examination of the inguinal region and the thigh should not be omitted. The hernial contents are often the omentum, and intestinal wall hernia (Richter hernia) is also not uncommon. The characteristics of hernia of the thigh are difficult to reduce, prone to incarceration and strangulation.

　　Hernia of the thigh is mainly divided into reusable hernia of the thigh and incarcerated hernia of the thigh. If a hernia of the thigh becomes incarcerated, in addition to causing local obvious pain, it often also has more obvious acute mechanical intestinal obstruction, and in severe cases, it can even cover the local symptoms of hernia of the thigh, making the patient suffer greatly. To prevent this disease, the following points should be done:

　　One, have confidence, patience, meticulousness, and keep an optimistic and pleasant mood, which is very beneficial for the care of hernias.

　　Two, when a hernia occurs for the first time, it should be paid enough attention and properly and effectively maintained. With daily walking and activities, it forms a habitual descent. Once it gets stuck at the orifice, it cannot be复位, causing intestinal necrosis, and needs to prevent the problem from getting worse.

　　Three, adhere to appropriate, moderate, and timely exercise, enhance physical fitness, improve the body's resistance to diseases, and never do strenuous activities such as jumping, stretching, pulling, holding heavy objects, etc., which is very不利于 the normal maintenance of hernias.

　　Four, pay attention to dietary adjustment, eat warm, cooked, and soft foods, avoid eating raw, cold, and hard foods, take less and more meals, prevent overeating, choose foods rich in nutrition and easy to digest and absorb, in order to reduce the burden on the gastrointestinal tract, and also to reduce the pressure on the hernia body.

　　Five, preventing constipation and keeping the bowels smooth is the key to preventing and protecting hernias. The abdominal wall of the elderly is weak, and due to constipation, the effort to defecate increases abdominal pressure, promoting the descent of the hernia body. This is difficult to control for the normal maintenance of hernias.

　　Hernia of the thigh is often caused by increased intra-abdominal pressure and relaxed inguinal ring, and is divided into reusable hernia of the thigh, incarcerated hernia of the thigh, and other types of hernia of the thigh. The examinations required for different types of hernia are also different:

　　1. The reusable hernia examination project mainly focuses on the check frame 'A';

　　2, For incarcerated femoral hernia with mechanical intestinal obstruction or severe condition, the examination case may include examination frames 'A' and 'B'

　　3, When the diagnosis is unclear or needs to be distinguished from other diseases, the examination case may include examination frames 'A' and 'B'.

　　Femoral hernia is often acquired later and commonly occurs in women. For femoral hernia patients, in addition to following the doctor's advice and taking medicine on time, it is also very important to pay attention to dietary health in daily life. So, what should femoral hernia patients eat and what should they avoid, and what should they eat to promote recovery?

　　What foods are good for femoral hernia patients?

　　1, Prefer warm, cooked, soft food, and take small and frequent meals.

　　2, In daily life, you can eat some foods with the effect of invigorating the body, such as mung beans, yam, chicken, eggs, fish, and meat.

　　What foods are bad for femoral hernia patients?

　　1, Avoid smoking, drinking alcohol, and drinking strong tea.

　　2, try not to eat or eat less spicy, raw scallions, pepper, and other irritant foods.

　　Femoral hernia dietary treatment methods

　　1, 50 grams of psoralea corylifolia, fried with salt and ground into powder, add 25 grams of black sesame, take 9 grams each time, twice a day

　　2, 120 grams of pork, wutong tree root, August melon root, and 10 grams of Xanthium sibiricum. Boil and take once a day.

　　3, 20 grams of garlic skin, boil water, take several times a day. Garlic skin is the skin attached to the garlic meat, about 1000 grams of garlic can peel off 20 grams of skin.

　　Femoral hernia is prone to incarceration, and once incarcerated, it can quickly develop into strangulation. Therefore, after the diagnosis of femoral hernia is confirmed, surgical treatment should be carried out in a timely manner. For incarcerated or strangulated femoral hernia, emergency surgery should be performed even more urgently.

　　The most commonly used surgical repair method is McVay repair. This method not only strengthens the posterior wall of the inguinal canal and is used for repairing inguinal hernia, but also can block the inguinal ring and is used for repairing femoral hernia. Another method is to suture the inguinal ligament, interstitial ligament, and pubic fascia together below the inguinal ligament after handling the hernia sac, thereby closing the inguinal ring. Tension-free hernia repair or laparoscopic hernia repair can also be adopted.

　　During the operation for incarcerated or strangulated inguinal hernia, because the hernia ring is small, it is often difficult to reduce the hernia contents. In such cases, the inguinal ligament can be cut to enlarge the inguinal ring. However, after the hernia contents are reduced, the cut ligament should be carefully repaired.